Psoriasiform pemphigus foliaceus: a report of two cases

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91229/1/j.1600-0560.2012.01866.x.pd

Epidermal Cysts in a Tacrolimus Treated Renal Transplant Recipient

Tacrolimus, a calcineurin inhibitor, formerly also known as FK506, is a macrolactam drug isolated from Streptomyces tsukubaensis. Its mode of action closely parallels the action of cyclosprorin A (CsA) and can be used for the treatment of inflammatory and autoimmune skin diseases in which systemic CsA has proved effective against psoriasis, pyoderma gangrenosum, atopic dermatitis, lupus erythematosus and graft versus host disease (GVHD). Although several cases of epidermal cysts have been reported in patients using cyclosporine and other immunosuppressants after organ transplantation; such types of cases have yet not been reported after administration of tacrolimus. However, we report herein a case of presence of multiple, various sized epidermal cysts in a renal transplant recipient receiving tacrolimus

Annular Leukocytoclastic Vasculitis in a Patient with Ulcerative Colitis

Leukocytoclastic vasculitis (LV) is characterized by neutrophilic invasion and fibrinoid necrosis along with endothelial enlargement in postcapillary venules. Annular appearance of LV (ALV) is rare, but it can be accompanied by several systemic diseases. One of these systemic diseases is ulcerative colitis (UC), a subgroup of inflammatory bowel disease. Only one case was previously reported in which ALV was associated with UC, and herein we present one more case. A 66-year-old woman presented with painful polycyclic erythema on both palms, which had been present for 4 days. She had suffered from UC for 5 years. The patient had no fever or other systemic symptoms, and histological examination demonstrated typical LV. 200 mg of oral dapsone was taken daily to rapidly reduce her symptoms and signs, and after 1 week all lesions resolved completely without any adverse events. ALV is not a distinct condition and it can appear in a broad range of small vessel vasculitides. Although ALV in patients with UC is a very rare combination, clinicians need to be aware of this possible association

The Protease Inhibitor Alpha-2-Macroglobuline-Like-1 Is the p170 Antigen Recognized by Paraneoplastic Pemphigus Autoantibodies in Human

Paraneoplastic pemphigus (PNP) is a devastating autoimmune blistering disease, involving mucocutaneous and internal organs, and associated with underlying neoplasms. PNP is characterized by the production of autoantibodies targeting proteins of the plakin and cadherin families involved in maintenance of cell architecture and tissue cohesion. Nevertheless, the identity of an antigen of Mr 170,000 (p170), thought to be critical in PNP pathogenesis, has remained unknown

Non-classical forms of pemphigus: pemphigus herpetiformis, IgA pemphigus, paraneoplastic pemphigus and IgG/IgA pemphigus

The pemphigus group comprises the autoimmune intraepidermal blistering diseases classically divided into two major types: pemphigus vulgaris and pemphigus foliaceous. Pemphigus herpetiformis, IgA pemphigus, paraneoplastic pemphigus and IgG/IgA pemphigus are rarer forms that present some clinical, histological and immunopathological characteristics that are different from the classical types. These are reviewed in this article. Future research may help definitively to locate the position of these forms in the pemphigus group, especially with regard to pemphigus herpetiformis and the IgG/ IgA pemphigus.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Dermatology DepartmentUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Dermatology and Pathology DepartmentsUNIFESP, EPM, Dermatology DepartmentUNIFESP, EPM, Dermatology and Pathology DepartmentsSciEL

The value of ultrahigh resolution OCT in dermatology - delineating the dermo-epidermal junction, capillaries in the dermal papillae and vellus hairs

Optical coherence tomography (OCT) imaging of the skin is gaining recognition and is increasingly applied to dermatological research. A key dermatological parameter inferred from an OCT image is the epidermal (Ep) thickness as a thickened Ep can be an indicator of a skin disease. Agreement in the literature on the signal characters of Ep and the subjacent skin layer, the dermis (D), is evident. Ambiguities of the OCT signal interpretation in the literatue is however seen for the transition region between the Ep and D, which from histology is known as the dermo-epidermal junction (DEJ); a distinct junction comprised of the lower surface of a single cell layer in epidermis (the stratum basale) connected to an even thinner membrane (the basement membrane). The basement membrane is attached to the underlying dermis. In this work, we investigate the impact of an improved axial and lateral resolution on the applicability of OCT for imaging of the skin. To this goal, OCT images are compared produced by a commercial OCT system (Vivosight from Michaelson Diagnostics) and by an in-house built ultrahigh resolution (UHR-) OCT system for dermatology. In 11 healthy volunteers, we investigate the DEJ signal characteristics. We perform a detailed analysis of the dark (low) signal band clearly seen for UHR-OCT in the DEJ region where we, by using a transition function, find the signal transition of axial sub-resolution character, which can be directly attributed to the exact location of DEJ, both in normal (thin/hairy) and glabrous (thick) skin. To our knowledge no detailed delineating of the DEJ in the UHR-OCT image has previously been reported, despite many publications within this field. For selected healthy volunteers, we investigate the dermal papillae and the vellus hairs and identify distinct features that only UHR-OCT can resolve. Differences are seen in tracing hairs of diameter below 20 ?m, and in imaging the dermal papillae where, when utilising the UHR-OCT, capillary structures are identified in the hand palm, not previously reported in OCT studies and specifically for glabrous skin not reported in any other in vivo optical imaging studies